Name

Dr. Karthikeyan M.A

Institute / Department

Interventional Radiology

Qualification

MBBS.,MD.,DrNB(EVIR).,EBIR

Designation

Conslt. Neuro Vascular Interventional Radiologist

Years in Practice

5

Procedures (Nos)

2000

Memberships

Tamil Nadu Medical Council European Board in Interventional Radiology

Expertise

Neuro Vascular Interventions Stroke - Mechanical Thrombectomy, Carotid Artery Stenting Brain Aneurysm - Simple Coiling I Balloon Assisted Coiling I Stent Assisted Coiling I Flow Diverter. Brain AVM I Dural AVF I Spinal AVM - Embolisation Peripheral Vascular Interventions Varicose Veins - Radio Frequency I Microwave I Laser I Venaseal Ablation. Peripheral Artery Disease! Critical limb Ischemia I Renal Artery Stenosis - Angioplasty & Stenting. Mesentric lschemia - Thrombolysis & Stenting Body Interventions Image Guided Biopsy & Drainage. Hemoptysis - Bronchial & Pulmonary Artery Embolisation Gastrointestinal Bleeding - Embolisation Vascular Malformation - Embolisaiton & Sclerotherapy Liver Interventions - TACE for Hepatocellular Carcinoma, TIPSS for Portal Hypertension, Hepatic Vein Stenting I DIPSS for Budd Chiari Syndrome, PTBD for Obstructive Biliopathy. Uterine Artery Embolisation for Fibroid Uterus, Post partum Hemorrhage, Uterine AVM. Prostatic Artery Embolisation for Benign Prostate Hyperplasia. Aortic Interventions Thoracic Aortic Aneurysm I Aortic Dissection - TEVAR Abdominal Aortic Aneurysm - EVAR


Medical Happenings

A Rare Case of Spinal AVM

70 Year old female had a difficulty in walking for past 1 year. She came to us in completely bedridden and inability to walk since last 1-2 weeks. She underwent MRI which showed Spinal Myelopathy due to Spinal Vascular Malformation. Our Interventional Radiologist performed Spinal Angiogram which showed Filum Terminale arteriovenous fistula causing Spinal Cord Congestion and Edema. After multi-disciplinary discussion she underwent surgical exclusion of the Filum Terminale Arteriovenous Fistula based on the anatomical localisation in Spinal Angiogram. Post-surgery, she was able to walk and regained her mobility. Filum Terminale Arteriovenous Fistula is rare condition and reported less than 100 cases in literature. Spinal Myelopathy due to Spinal Vascular Malformation can be completely cured if and treated early and appropriately.


Youngest Thrombectomy For Stroke in Salem

A 20 years Male, had left upper limb pain for 4 months and ring finger tip blackening since 20 days. He presented to hospital with stroke symptoms in drowsy state with left hemiplegia (Inability to move left side of body). He underwent CT Angiogram and MRI which showed Embolic occlusion to basilar artery with associated left sub clavian artery occlusion due to Thoracic outlet obstruction. He underwent Emergency Mechanical Thrombectomy for basilar artery with successful recovery. This is a rare and unusual case of major stroke. This is the youngest patient treated by Mechanical Thrombectomy in this region.


Balloon-occluded Retrograde Transvenous Obliteration of Varices

A 60 year female had chronic liver disease with portal hypertension.Recurrent Upper Gastrointestinal Series bleed due to bleeding from large gastric varices.  UGI scopy confirmed the bleeding from gastric varices.  She underwent BRTO with successful control of bleeding.
We enter from Right femoral vein - IVC - renal vein -Gastro renal shunt. Occluded gastro renal shunt using balloon/coil/plug and obliterate the gastric varices with sclerosant mixture. We study the feasibility,afferents ,efferents of varices using Contrast-enhanced computed tomography which guides for treatment. Gastric varices are predominantly submucosal unlike esophageal varices .So watever seen in endoscopy is only tip of iceberg and hence the complete elimination of gastric varices is difficult by endoscopic methods and more chances of recurrence.  Thanks to the Gastroenterologist team.


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